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Centene

Runs government-backed health insurance plans

Vice President – Network Development & Contracting

Business OperationsConfirmed live in the last 24 hours
Full-timeFlorida, USA$207k - $392.1k /yr

About the Job

Requirements

  • A bachelor's degree or equivalent in Business Administration, Healthcare Administration, or a related field is required.
  • At least 10 years of network development and provider relations or contracting management experience in a healthcare or managed care environment is required.
  • Previous management experience with responsibilities for hiring, training, assigning work, and managing staff performance is required.
  • A valid driver's license is required.

Responsibilities

  • Oversee provider network and contracting-related activities.
  • Lead provider network strategy, including access analysis and network operations, and support decision makers with analysis related to reimbursement and unit cost management.
  • Oversee coordination and negotiation for the contracting department, including analysis of information to support contract negotiations.
  • Ensure development of provider networks across expansion markets.
  • Evaluate provider network cost, coverage, and growth, and recommend expansion opportunities.
  • Oversee budgeting and forecasting initiatives for network costs and provider contracts across various product lines.
  • Review provider contracting rates to ensure strategic alignment with overall company strategy.
  • Participate in unit cost and selective contracting initiatives.
  • Establish the department’s strategic vision, objectives, policies, and procedures, including developing, implementing, and maintaining production and quality standards.
  • Support market expansion and M&A activities by leading provider contract analysis related to due diligence.
  • Assist health plan CEOs and/or COOs, vendors, and others in key provider relations and strategy.
  • Perform other duties as assigned.
  • Comply with all policies and standards.

Desired Qualifications

  • MBA or MHA degree preferred.
  • Experience with contracting for Medicaid, Medicare, and Marketplace lines of business covering the Florida market.

About the Company

Centene

Runs government-backed health insurance plans

Centene runs government-backed health insurance plans in the United States, with Medicaid as its largest business alongside Medicare and Affordable Care Act Marketplace coverage. It is one of the largest Medicaid insurers in the country and also runs plans for people eligible for both Medicare and Medicaid, long-term care and children in foster care. States and the federal government pay Centene a set amount per member to manage care, and individuals buy its Ambetter Marketplace plans, often with federal subsidies. Centene contracts with local doctors, hospitals and pharmacies and keeps the difference between premiums and the cost of care. The company was founded in 1984 in Milwaukee and is headquartered in Clayton, Missouri.

Company size
10,001+
Company stage
IPO
Headquarters
Clayton, MO
Founded
1984

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